RESUMO
We aimed to investigate whether interleukin-10 (IL-10) -1082 G/G genotype is associated with lower mortality of acute respiratory distress syndrome (ARDS) in a Chinese population. A hospital-based case-control study was conducted in 314 cases of ARDS and 210 controls who were admitted to an intensive care unit with sepsis, trauma, aspiration or massive transfusions. Cases were followed for 30-day mortality. The -1082G/G genotype was associated with lower development of ARDS (OR=0.51; 95% CI 0.34-0.76; P=0.001). Among patients with ARDS, the -1082G/G genotype was associated with lower 30-day mortality (OR=0.44; 95% CI 0.25-0.76; P=0.003). In conclusion, IL-10-1082 G/G genotype is associated with lower development and mortality of ARDS in a Chinese population.
Assuntos
Interleucina-10/genética , Síndrome do Desconforto Respiratório/genética , Síndrome do Desconforto Respiratório/mortalidade , Adulto , Idoso , Povo Asiático/genética , Estudos de Casos e Controles , Primers do DNA/genética , Feminino , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de RestriçãoRESUMO
We investigate whether interleukin-10 (IL-10)-1082 G/G genotype is associated with the mortality rate of acute respiratory distress syndrome (ARDS) in a hospital-based case-control study in China conducted on 314 patients with ARDS and 210 controls admitted to an intensive care unit for sepsis, trauma, aspiration, or massive transfusions. IL-10-1082 promoter polymorphisms were analyzed with polymerase chain reaction amplification followed by restriction fragment length polymorphism. Mortality was recorded if it occurred within 30 days from admission. The -1082G/G genotype was associated with lower frequency of ARDS (odds ratios=0.51; 95% confidence intervals: 0.34-0.76; p=0.001), and in patients with ARDS, it was associated with lower mortality within 30 days (odds ratios=0.44; 95% confidence intervals: 0.25-0.76; p=0.003) than in controls. We conclude that IL-10-1082 G/G genotype is associated with a decreased rate development of ARDS and mortality in this Chinese population.
Assuntos
Povo Asiático/genética , Interleucina-10/genética , Polimorfismo Genético , Síndrome do Desconforto Respiratório/genética , Síndrome do Desconforto Respiratório/mortalidade , APACHE , Idoso , Estudos de Casos e Controles , China , Feminino , Predisposição Genética para Doença , Genótipo , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de RestriçãoRESUMO
We analyzed the clinical manifestations and experiences of diagnosing and treating central pontine myelinolysis following living donor liver transplantation. The clinical data of three patients with central pontine myelinolysis following living donor liver transplantation from January 2005 to November 2007 were retrospectively analyzed at the West China Hospital, Sichuan University, China. The three patients developed hyponatremia prior to surgery. Case 1 suffered locked-in syndrome following surgery, and received a large dose of gamma globulin, and subsequently recovered. Case 2 was in a coma for three days, and received hyperbaric chamber treatment. This patient remained in a mild coma for six months following surgery. Case 3 developed consciousness disturbances, gradually went into a coma following surgery, and died due to pulmonary infection. Central pontine myelinolysis is a severe complication in patients following living donor liver transplantation. Large-dose gamma globulin treatment, as well as hyperbaric oxygen, might be effective therapeutic methods.
Assuntos
Transplante de Fígado/efeitos adversos , Doadores Vivos , Mielinólise Central da Ponte/etiologia , Mielinólise Central da Ponte/terapia , Evolução Fatal , Feminino , Hidratação , Humanos , Hiponatremia/complicações , Imunossupressores/uso terapêutico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mielinólise Central da Ponte/diagnóstico , Mielinólise Central da Ponte/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapiaRESUMO
OBJECTIVE: To retrospectively analysis the treatment characteristics of the systemic situation in patients with crush syndrome after Wenchuan earthquake happened in May 12th, 2008. METHODS: Forty-nine patients with crush syndrome and subsequent acute renal failure (ARF) due to the earthquake were treated in West China Hospital. All of patients had been rescued from buildings that collapsed in Wenchuan earthquake. The major associated injuries were in the low extremities and upper extremities. 49 patients developed ARF with increased concentrations of serum creatinine (mean 64 022 U/L) had underwent haemodialysis. Hyperkalaemia was seen in 9 patients and four of them underwent haemodialysis. 49 patients were administered hemodialysis. RESULTS: No patient died. All patients who suffered from the ARF were weaned from hemodialysis after admitted 7 to 35 days. Forty-five extremities underwent amputations and 52 extremities had fasciotomy. CONCLUSIONS: Crush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF. The authors believe that immediate intensive care therapy and multi-subjective coordination would have improved the survival rate.
Assuntos
Injúria Renal Aguda/terapia , Síndrome de Esmagamento/cirurgia , Terremotos , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/cirurgia , Adolescente , Adulto , Idoso , Amputação Cirúrgica , Criança , Síndrome de Esmagamento/etiologia , Síndrome de Esmagamento/terapia , Descompressão Cirúrgica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia de Substituição Renal , Estudos Retrospectivos , Resultado do Tratamento , Ferimentos e Lesões/complicaçõesRESUMO
We reported the first case of simultaneous pancreas-kidney transplantation (SPK) in our hospital. The recipient is a 65 year old male, who suffered type 2 diabetes for 15 years and renal dysfunction for 5 years and other diabetic complications such as retinopathy, peripheral neuropathy. SPK was performed successfully for him in March, 2007, in which the donor kidney was put in left iliac fossa, while the donor pancreas grafted to set in right iliac fossa of recipient, with pancreas exocrine drainage controlled by anastomosis to the small bowel and endocrine release done to the circulatory system. Serum C-peptide, Creatinine and Blood urea nitrogen became normal levels at day 1, 4 and 11 of post-operation respectively. The concentration of blood glucose was stabilized gradually to normal level and therefore the injected insulin was stopped using to the patient at day 16 of post-operative days. OGTT test showed the function of grafted pancreas was normal 3 weeks after transplant, and no transplantation-related complications occurred. With the recipient followed up for 6 months, both his blood glucose level and renal function maintained normal without using injected insulin, and he was getting to recover from other diabetic complications also.